Date: Tue, 20 Jul 1999 15:35:08 -0700

Dear Dr. R...:

I understand that you are a very caring and informed doctor.

In the silicone issue, however, you may still be unaware of the extraordinary amount of accurate information regarding the systemic illnesses associated with long term implantation. Unfortunately, all of the scientific groups who have recently reported on implants (Institute of Medicine, National Science Panel, etc.) have all reviewed the same, small, short studies funded by the manufacturers after litigation began. They do not reflect the scores of thousands of case reports of women with systemic diseases. The recent IOM review did reveal, however, the severity of local complications and acknowledged the extraordinarily high rate of rupture that it increased substantially over time.

It is for this reason, that I appeal to you and the Plastic Surgery Department at Kaiser to re-evaluate the wisdom of waiting until a woman presents with severe problems and/or rupture before approving removal and capsulectomy en bloc. It's analogous to Exxon waiting for the Valdez to crash again! Not a good idea.

I have an International Support Group for women and their families harmed by breast implants and other silicone products that numbers in the thousands and grows daily. Science may enjoy a slow, circuitous route to uncovering the mystic of systemic damage from implants, but the women do not have this luxury.

One of my group pointed out this quote taken from the Kaiser Permanente page on the internet regarding scleroderma. As you know, this disease is very rare. Even the oft quoted NEJM studies admitted that to detect an increase in this debilitating and painful syndrome, over 60,000 women would have to have been examined. Less than a thousand were. We have a large population of implanted women with scleroderma in my group. Here is the quote from your webpage: "Many possible causes of Scleroderma and other "sclerosis-like" connective tissue diseases are currently being investigated. These include a wide variety of chemical and environmental exposures (e.g., vinyl chloride, pentazocine, silicone, tricholorethylene, paraffin), as well as the use of adulterated L-tryptophan and appetite suppressants."

I have included a copy of my booklet with many references for your information. Please let me know what can be done to hasten Kaiser's realization that early removal will prevent future serious complicatons from implants. The FDA has never approved them for safety for a very good reason.

Best regards,

Ilena Rosenthal

Director, Humantics Foundation for Women Breast Implants: Recovery & Discovery